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Septicemia Caused by Leuconostoc lactis with Intrinsic Resistance to Vancomycin in a Patient with Biliary Stent
J. Exp. Biomed. Sci. 2013;19:280-283
Published online September 30, 2013
© 2013 The Korean Society For Biomedical Laboratory Sciences.

Kyeong Seob Shin1, Kyudong Han2 and Seung Bok Hong3,†

1Department of Laboratory Medicine, Chungbuk National University, College of Medicine, Cheongju 361-711, Korea
2Department of Nanobiomedical Science & BK21 PLUS NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan 330-714, Korea
3Department of Clinical Laboratory Science, Chungbuk Health & Science University, Cheongwon 363-794, Korea
Correspondence to: Seung Bok Hong. Department of Clinical Laboratory Science, Chungbuk Health & Science University, Cheongwon 363-794, Korea.
Tel: +82-43-210-8308, Fax: +82-43-210-8289
e-mail: sbhong8646@hanmail.net
Received June 19, 2013; Revised August 30, 2013; Accepted September 26, 2013.
 Abstract
Leuconostoc spp. is intrinsically resistant against vancomycin and rarely causes the infection in immunocompromised patients. In this report, we describe a fatal case of Leuconostoc lactis bacteremia in a patient with biliary tract stent insertion to resolve the biliary tract obstruction by multiple pseudocysts in the pancreatic head region. Leuconostic lactis isolated from the blood of the patients was confirmed by 16S rRNA sequencing and this isolate was susceptible against most antibiotics, including levofloxacin, penicillin, erythromycin and cefotaxime except vancomycin. The septic shock and multi-organ failure was abruptly progressed due to delayed use of adequate antibiotic. Using vancomycin as the empirical antibiotics in a bacteremic patient by Gram positive cocci, the treatment failures by the isolates with intrinsic resistance against vancomycin have to be considered. In addition, the prompt and accurate identification of Leuconostoc spp. are very important to select the adequate antibiotics.
Keywords : Leuconostoc lactis, Bacteremia, 16S rRNA sequencing, Vancomycin resistance